The evolving language of addiction: Your words matter to your patients

By Jules Murtha | Fact-checked by Barbara Bekiesz
Published December 16, 2022

Key Takeaways

  • Those who struggle with substance use disorders often deal with the stigma of being perceived as dangerous, incapable of recovering, or blamed for the state of their condition.

  • To help destigmatize patients who deal with substance misuse, clinicians can use person-first language and scientifically accurate terminology when talking about addiction.

  • Examples of non-stigmatizing language include “return to use” (instead of “relapse”), “drug misuse” (instead of “drug abuse”), and “person in active use” (instead of “junkie”).

“The only constant in life is change.”

This quote from Heraclitus didn’t specifically refer to the evolving nature of medical terminology, or the consequences of stigmatizing language. Yet, it perfectly applies to research on the language of addiction, which urges clinicians to rethink how they speak about the disease.

The link between language and stigma

The US government has recognized the harsh effects of stigmatizing language on patients with substance use disorders.

A 2017 memo written by Michael P. Botticelli, the former director of the White House Office of National Drug Control Policy, recognized how stigmatizing language may negatively alter societal perceptions of people with substance use disorders.[]

According to Botticelli, although people with substance use disorders are capable of recovery, “sometimes the terminology used in the discussion of substance use can suggest that problematic use of substances and substance use disorders are the result of a personal failing; that people choose the disorder, or they lack the willpower or character to control their substance use.”

This, along with the perception that those who use substances are dangerous, could converge to create a stigma associated with substance use that can do real damage. This is especially true for women and mothers, who often have poor self-esteem, depression, fear, and anxiety as a result of addiction-related stigma.

A 2021 article published by the NIH stated that stigma has the power to prevent patients with substance use disorders from seeking proper treatment, as well as negatively affecting physicians’ understanding of them.[] This may ultimately influence the quality of care they receive.

Person-first language

Researchers urge doctors to adapt their terminology by using person-first language.

Person-first language is defined by the NIH as language that “maintains the integrity of individuals as whole human beings by removing language that equates people to their condition or has negative connotations.”[]

But what does person-first language sound like? What vocabulary should be used in the hallways and the exam room, when referring to substance use disorders and the patients who struggle with them?

Read Next: Identifying drug-seeking behaviors in your patients

Different ways to describe substance use

When it comes to changing the language of addiction, there are a few concrete terms and phrases to use in place of potentially stigmatizing ones.

According to the NIH and an article published by StatNews.com, this list of revised, person-first terms is as follows:[]

  • Abuse → Use, misuse, or used other than prescribed

  • Addict → Person with substance use disorder

  • Alcoholic → Person with alcohol use disorder

  • Junkie → Person in active use

  • Relapse → Return to use

  • Former addict → Person in recovery or person in long-term recovery

Taking liberties

Note that these changes in terminology apply to the preferred language for clinicians to use.  Patients who struggle with substance use disorders may still refer to themselves as addicts, junkies, or other descriptors. But that is their choice.

Botticelli elaborated on the nuances of language surrounding addiction in the StatNews.com article.

"When you’re a member of a community, you have certain liberties in terms of what you call yourself, and those liberties are not extended, necessarily, to other people. "

Michael P. Botticelli, former director, White House Office of National Drug Control Policy

Ultimately, it’s a patient’s prerogative to find the best terms to describe their experience. It’s a physician’s job to support them.

What this means for you

Stigma plays a significant role in how society, and the medical profession itself, views patients with substance use disorders. To help neutralize the terminology surrounding substance misuse, clinicians can use person-first language, while allowing patients to choose their own self-descriptors. Changing your language may help destigmatize these patients.

Read Next: Relapse after successful therapy: How physicians can encourage long-term recovery
Share with emailShare to FacebookShare to LinkedInShare to Twitter
ADVERTISEMENT